[Candida infection of the female genitalia. Complaints and clinical findings]

Lachenicht P
Med Klin (Germany, West) Jan 31 1969, 64 (5) p203-6

No abstract.

Dietary supplement of neosugar alters the fecal flora and decreases activities of some reductive enzymes in human subjects.

Buddington RK; Williams CH; Chen SC; Witherly SA
Department of Biological Sciences, Mississippi State University, Mississippi State 39762-5759, USA.
Am J Clin Nutr (United States) May 1996, 63 (5) p709-16

The influence of dietary fructooligosaccharide (neosugar) on the fecal flora and activities of reductive enzymes was studied in 12 healthy, adult human subjects fed a controlled diet for 42 d and given 4 g neosugar/d between days 7 and 32. Fecal samples were collected before, during, and after supplementation with neosugar to enumerate total anaerobes, aerobes, bifidobacteria, and enterobacteria, and to assay for beta-glucuronidase, nitroreductase, and glycocholic acid hydroxylase. Although the controlled diet caused an increase in total anaerobes and bifidobacteria, the highest densities occurred during supplementation with neosugar. Total aerobes and enterobacteria were less affected by diet and neosugar. Neosugar caused beta-glucuronidase and glycocholic acid hydroxylase activities to decrease 75% and 90%, respectively; both increased after supplementation with neosugar was stopped. Nitroreductase activity declined 80% after the control diet was started, but was not affected by neosugar. These findings indicate that 4 g neosugar/d alters the fecal flora in a manner perceived as beneficial by decreasing activities of some reductive enzymes.

In vitro fructooligosaccharide utilization and inhibition of Salmonella spp. by selected bacteria.

Oyarzabal OA; Conner DE
Department of Poultry Science, Auburn University, Alabama 36849-5416, USA.
Poult Sci (United States) Sep 1995, 74 (9) p1418-25

In vitro experiments were conducted to determine:

1) inhibitory capacities of potential direct-fed microbial bacteria against Salmonella serotypes; and

2) the ability of Bifidobacterium bifidum, Enterococcus faecium, Lactobacillus casei, Lactococcus lactis, Pediococcus sp., and Salmonella spp. to grow in media containing fructooligosaccharides (FOS-50 or FOS pure formulation) as the only carbohydrate source.

Thirteen bacteria (two strains of Bacillus coagulans, Bacillus licheniformis, Bacillus subtilis, B. bifidum, E. faecium, two strains of Lactobacillus acidophilus, L. casei, Pediococcus sp., Propionibacterium acidopropionici, P. jensenii, and Propionibacterium sp.) were tested for inhibition of six Salmonella serotypes (S. california, S. enteritidis, S. heidelberg, S. mission, S. senftenberg, and S. typhimurium) using a spot-the-lawn technique. Bifidobacterium bifidum, E. faecium, all lactobacilli, and Pediococcus sp. clearly inhibited growth of all Salmonella serotypes. In the growth experiments, E. faecium, L. lactis, and Pediococcus sp. grew in media with either FOS-50 or the pure formulation of FOS as the sole carbohydrate source. All tested Salmonella serotypes utilized FOS-50 for growth; however growth varied among the serotypes. In contrast, none of the Salmonella serotypes grew in media containing the pure formulation of FOS as the only carbohydrate source.

Dietary fructooligosaccharide, xylooligosaccharide and gum arabic have variable effects on cecal and colonic microbiota and epithelial cell proliferation in mice and rats.

Howard MD; Gordon DT; Garleb KA; Kerley MS
Department of Animal Science, University of Missouri, Columbia 65211, USA.
J Nutr (United States) Oct 1995, 125 (10) p2604-9

Two experiments were conducted to determine if supplementing soluble fiber (fructooligosaccharide, xylooligosaccharide or gum arabic) to a semi-elemental diet would beneficially change cecal and colonic microbiota populations and enhance epithelial cell proliferation. Experiments 1 and 2 used identical dietary regimens; mice and rats were given free access to a powdered semi-elemental diet. Animals were assigned to one of the four following treatment groups: control, no supplemental dietary fiber, fructooligosaccharide, xylooligosaccharide and gum arabic. Dietary fiber was supplied via drinking water at 30 g/L. In Experiment 1 populations of Bifidobacteria and total anaerobic flora were enumerated from the contents of the cecum and colon of weanling mice. Consumption of fructooligosaccharide increased (P < 0.05) the concentrations of Bifidobacteria and the ratio of Bifidobacteria to total anaerobic flora. In Experiment 2 tissue from the cecum and distal colon of weanling rats was examined for morphological changes of the mucosa. Consumption of xylooligosaccharide increased (P < 0.05) cecal crypt depth and labeling index relative to the other three treatments. Consumption of gum arabic and the control diet increased (P < 0.01) cecal proliferation zone. Consumption of xylooligosaccharide and the control diet increased (P < 0.01) cecal cell density (number of cells in a vertical-half of the crypt). Distal colonic crypt depth was greatest (P < 0.05) in controls and rats fed fructooligosaccharide, intermediate in those fed gum arabic, and smallest in those fed xylooligosaccharide. These results suggest that fructooligosaccharide effectively stimulates growth of Bifidobacteria and xylooligosaccharide supports a modest enhancement of cecal epithelial cell proliferation.

A comparison of susceptibility to five antifungal agents of yeast cultures from burn patients.

Still JM Jr; Law EJ; Belcher KE; Spencer SA
Augusta Regional Medical Center, Georgia, USA.
Burns (England) May 1995, 21 (3) p167-70

Patients with significant degrees of immunocompromise, such as cancer, AIDS and large burns, who have received significant amounts of antibiotics, may develop infections with yeast organisms. Over a 3-year period, all patients with positive fungal blood cultures and most wounds of patients with large burns considered to be a risk of yeast infection were selected and tested for their susceptibility to five antifungal agents, amphotericin B, ketoconazole, miconazole, diflucan, and 5-fluorocytosine. In all, 244 specimens of yeast were tested: 142 Candida albicans, 52 Candida parapsilosis, 26 Candida tropicalis and 13 Trichosporon beigelii. A limited number of other isolates of Candida (12) were also encountered. All Candida organism were sensitive to amphotericin B. There was wide variation in regard to the susceptibility to the other four agents, with C. albicans and C. tropicalis being largely resistant to miconazole and ketoconazole. T. beigelii was recovered in 13 patients. One-half of these organisms was resistant to amphotericin B. Awareness of variations in species and susceptibility are helpful in the selection of appropriate therapeutic antifungal agents.

[A trial of the use of diflucan (fluconazole) in patients with vaginal candidiasis]

Dmitrieva NV, Sokolova EN, Makhova EE, Petukhova IN
Antibiot Khimioter 1993 Dec;38(12):39-41

Fifty females with vaginitis due to Candida albicans were treated with fluconazol (diflucan) in a single dose of 150 mg administered per os. A complete elimination of the clinical signs in 42 out of 50 patients (84 per cent) and a significant improvement of the clinical picture in 4 out of 50 patients (8 per cent) were recorded. The cultures of the smears produced no fungal growth with respect to 31 out of 36 patients (86.1 per cent), while microscopically the presence of the fungus with the signs of pathomorphosis was detected. Such cells could be a source of the fungal reinfection. Therefore, diflucan proved to be a highly efficient drug in the treatment of vaginal candidiasis and might be considered as an additional agent for the therapy of the disease.

[Fluconazole--a new antifungal agent]

Dobloug JH
Infeksjonsmedisinsk avdeling, Ulleval sykehus, Oslo.
Tidsskr Nor Laegeforen 1992 Jun 10;112(15):1961-3

Fluconazole (Diflucan) is a new triazole antifungal agent that is effective against a wide range of fungi and has a favourable pharmacokinetic profile. Fluconazole is absorbed well after oral intake independent of food intake. Fluconazole is given once daily, in a dose of 50-400 mg. The dosage is the same for oral and parenteral administration. Tissue penetration is good, as is the concentration in cerebrospinal fluid. Fluconazole should not be given to children under 16 years of age, nor to pregnant or breast-feeding women. In Norway, fluconazole is indicated for treatment of candida vaginitis that is resistant to other treatment, invasive candida infection, candida stomatitis in immunocompromised hosts, and cryptococcalmeningitis.

[Endogenous candida endophthalmitis: a new therapy]

Mistlberger A, Graf B
Augenabteilung der Landeskrankenanstalten Salzburg.
Klin Monatsbl Augenheilkd 1991 Dec;199(6):446-9

A thirty-year-old patient underwent an extensive abdominal surgery because of a precancerosis due to a colitis ulcerosa. An accompanying smoldering panuveitis led under immunosuppressive therapy to the loss of sight of one eye. Only an increasing vitritis of the second eye allowed the diagnosis of an endogenous Candida endophthalmitis (ECE) following a vitrectomy. A systemic administration of the common antifungal medications was impossible because of the patient's pathological blood-picture and a severe cholestasis. We report the successful use of Fluconazol (Diflucan), an antimycotic agent we never used before in this connection.

"Perspective Evaluation of Candida Antigen Detection Test For Invasive Candidiasis and Immunocompromised Adult Patients With Cancer"

Escuro, Ruben S., M.D., et al
The American Journal of Medicine, December 1989;87(621-627)

No abstract.

"Pathogenesis of Candidiasis: Immunosuppression By Cell Wall Mannan Catabolites"

Podzorski, Raymond P., Ph.D., et al
Archives of Surgery, November 1989; 124:1290-1294

No abstract.

Vaginitus and yogurt consumption

[No author listed]

Thirteen female patients, with chronic yeast candidiasis, finished a study in which they ingested 8 ounces of yogurt with a live lactobacillus culture for 6 months. The lactobacillus acidophilus species was noted to produce hydrogen peroxide. There was a threefold decrease of infections in patients consuming yogurt containing lactobacillus acidophilus. The mean number of infections for 6 months was 2.54 in the control group, versus .38 in those containing yogurt. The colonization of yeast decreased from 3.23 per 6 months in the control arm to .84 in the yogurt arm. It is concluded that daily ingestion of yogurt containing lactobacillus acidophilus decreased candidal colonization and infection.

Garlic

[No author listed]

This is an extensive review article on the physiologic aspects of garlic with regards to cancer prevention and treatment. This article lists approximately 30 studies from 1949 through 1986 on garlic and cancer. Epidemiologically garlic and onion consumption is associated with reduced mortality from cancer. Garlic is rich in sulfur compounds and may be important in several detoxification pathways. Garlic has antitumor and cancer inhibition properties. There is presently no data from the National Toxicology Program regarding the toxicity of garlic though in animal models negative health effects at very high doses have been reported. Other documented effects of garlic include antiobiotic and antifungal activity, fibrinolysis and platelet aggregation inhibition. The trace elements selenium and germanium, antioxidants in their own right, are constituents of Japanese garlic. Further studies in humans on garlic and cancer are encouraged.

"Garlic: A Review of Its Relationship to Malignant Disease"

Dausch, Judith G., Ph.D., RD and Nixon, Daniel W., M.D.
Preventive Medicine, May 1990;19(3):346-361

This review states that Kyolic garlic extract enhanced the elimination of candida albicans in infected animals. Kyolic can inhibit aflatoxin or benzopyrene induced mutagenesis. It can also inhibit aflatoxin from binding to DNA. Garlic reduces the formation of organosoluble metabolites and increases the formation of water soluble metabolites facilitating elimination of the carcinogen.

"Anticandidal and Anticarcinogenic Potentials For Garlic"

Tadi, Padma P., MS, et al
International Clinical Nutrition Review, October 1990;10(4):423-429.

Vaginal Flora

This article reviews the role of the vaginal flora and the pathogenesis and prevention of urinary tract infections. It is noted that antimicrobial agents and spermacides can disrupt the vaginal flora making the patient more susceptible to bladder and vaginal infections. Supplementation of lactobacillus strains have some clinical potential. Also immunizations have shown some promise as well. Lactobacilli dominate the vaginal flora of healthy women. They help maintain low vaginal pH by the production of lactic acid, compete for space on the vaginal epithelium, produce hydrogen peroxide and antimicrobial substances, and stimulate immune function. Systemic antibiotic administration can definitely alter vaginal flora. Recent studies of prophylactic antimicrobial treatment have shown an increased susceptibility to reinfection. Induction in monkey models of ecoli colonization from Amoxicillin use has been corrected with indigenous organism supplementation including lactobacilli. Long term use of antibiotics for prostatitis has been found to destroy the normal urethral flora that would otherwise interfere with virulent organisms. The spermicide nonoxynol-9 can also affect the urogenital flora negatively. The uropathogens and candida albicans were found to survive in up to 25% concentration of this product and grow and adhere better to cells when exposed to nonoxynol-9. Patients who use spermacides may be more susceptible to repeated infections by yeast and bacteria. It may be that estrogen has an effect on the normal flora and that susceptibility to infection is increased during fluctuations of female hormones. A direct linkage with hormones has not been proven yet. The application to prevent urinary tract infections with lactobacilli is a relatively new concept. In the authors' work 16 commercial lactobacillus products were examined; 11 were found to be contaminated with pathogens and only 4 contained the lactobacillus acidophilus as stated on the label. There is evidence from the literature that lactobacilli can prevent urogenital as well as intestinal infections. In one study freeze dried lactobacilli suppositories were given intravaginally once weekly for 1 year to 8 patients with recurrent UTI's. The results showed an impressive 78% reduction in the incidence of infection. It is possible that stimulation of IgA antibodies may help prevent urinary tract infections as well. This has been attempted by using a product called Urovac (Solco-Basel, Switzerland) that is comprised of killed, whole, uropathogenic bacteria. This therapy was given intramuscularly 3 times a week with a follow-up at 12 months. There was a reduction in immunized patients developing UTI compared to controls. This protection was correlated later with increased urinary IgA antibodies. It is not known how injections of uropathogens could cause bladder IgA antibodies. The use of oral vaccinations using e. coli membranes raises similar questions. The authors conclude that there is a potential for vaccination to prevent urinary tract infections as well as chronic vaginal candidiasis. A subcutaneous vaccine for candida ribosomes and adjuvant proteoglycans for klebsiella pneumonia was given orally in capsule form to 22 women at a dose of 2 to 9 capsules a day for 4 days over a 3 week period, and then for 4 consecutive days a month for 5 months. Vulvovaginitis was reduced from 3.6 to .6 attacks per 6 months.

"Vaginal Flora and Urinary Tract Infections"

Reid, Gregor, Ph.D., et al
Current Opinion in Infectious Disease, 1991;4:37-41

No abstract.

Candida Albicans

[No author listed]

It is suspected that in recurrent candida albicans vaginitis there is a decreased cellular immune response. This study evaluated the role of circulating progesterones and the effect on immune response to candida albicans. There was approximately a 50% decrease in candida albicans-induced lymphocyte proliferation observed in the presence of luteal phase levels of progesterone 25 mg/ml, as opposed to the proliferative phase of .15 mg/ml. It appears that progesterone inhibits lymphocyte proliferation through a monocyte- dependent mechanism. There also appear to be individual differences in the capacity of a person's monocytes to down regulate the lympho- cyte response to candida albicans. The authors conclude that fluctuations in a woman's monocyte activity, in response to genetic, hormonal and environmental factors, may affect her cell mediated immune response to candida albicans. Identifying highly susceptible females along with augmentation of the cellular immune response to candida albicans may be of benefit in preventing recurrent candida vaginitis.

"Regulation of The Immune Response to Candida Albicans by Monocyte and Progesterone"

Kalo-Klein, Aliza, Ph.D. and Witkin, Steven S.
American Journal of Obstetrics and Gynecology, 1991;164:1351-4

No abstract.

Hydrogen Peroxide Producing Organisms

[No author listed]

Lactobacillus in the vaginal tract produces hydrogen peroxide. It is present in 96% of normal vaginas but is absent in women suffering from chronic vaginosis. It is noted that the production of hydrogen peroxide by lactobacilli can be toxic to Gardenerella vaginalis. Hydrogen peroxide, halides such as chlorides, and enzyme peroxidase are toxic to the reproduction of bacteria, viruses and mammalian cells. Chloride and peroxidase are found in the cervical mucus and at certain levels in the vaginal fluid. Hydrogen peroxide is produced by lactobacilli. The author states that there may be a simple procedure of recolonization of the vagina, using peroxide producing bacteria and thereby eliminating the vaginosis.

"Hydrogen Peroxide-Producing Organisms Toxic To Vaginal Bacteria"

Infectious Disease News, August 8, 1991;5

No abstract.

Vaginal Ecosystem

[No author listed]

Things that can change the vaginal flora include:

1) antibiotics, corticosteroids, antiviral and antifungal agents, irradiation,
2) vaginal douching,
3) malformation and anatomic deformity after surgery or radiation,
4) cysts, hymen, polyps,
5) immunosuppressive conditions such as AIDS,
6) hormonal changes, use of oral contraceptives or medicinal therapies,
7) uncontrolled diabetes,
8) foreign objects, i.e.
9) intrauterine devices or retained tampon or diaphragm
10) and spermicides.

The vaginal flora is highly susceptible to numerous endogenous and exogenous influences. It is noted that the current belief is the intestinal tract is a reservoir for organisms found in the vagina of women with bacterial vaginosis.

"The Vaginal Ecosystem"

Mardh, Per-Anders, M.D.
Mardh, Per-Anders, M.D., American Journal of Obstetrics and Gynecology, October 1991;165(4): Part II:1163-1168.

No abstract.

Candida Vaginitis, Lactobacillus Acidophilus and Yogurt

[No author listed]

In 33 patients with recurrent candida vaginitis, there was found a three-fold decrease in infections when patients consumed yogurt containing lactobacillus acidophilus for a period of 6 months. The mean number of infections per 6 months was 2.54 in the control group, and .38 per 6 months in the yogurt treated group. Candida colonization decreased from a mean of 3.23 per 6 months in the control group to .84 for 6 months in the yogurt group. The authors conclude that daily ingestion of 8 ounces of yogurt containing lactobacillus acidophilus decreased both candida colonization and infection. It is thought that candida is autoinoculated since identical strains are seen in the mouth, anus and vaginal areas. Other studies have shown that gastrointestinal colonization does not have much to do with vaginal reoccurrences. There was an association between the presence of lactobacillus species in the rectum and the vagina. Yogurt ingestion had a marked effect on the incidence of candida infection in the vagina and the rectum. The lactobacillus strains in yogurt were found to produce hydrogen peroxide. The authors feel that a gastrointestinal strain of lactobacillus acidophilus colonized the vaginal tract of their patients.